<h4>Objective</h4>To summarize the principles and application of phototherapy consistent with the current 2022 American Academy of Pediatrics "Clinical Practice Guideline Revision for the Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation."<h4>Methods</h4>Relevant literature was reviewed regarding phototherapy devices in the United States, specifically those that incorporate blue to blue-green light-emitting diode, fluorescent, halogen, or fiberoptic light sources, and their currently marketed indications.<h4>Results</h4>The efficacy of phototherapy devices varies widely because of nonstandardized use of light sources and configurations and irradiance meters. In summary, the most effective and safest devices have the following characteristics: (1) incorporation of narrow band blue-to-green light-emitting diode lamps (∼460-490 nm wavelength range; 478 nm optimal) that would best overlap the bilirubin absorption spectrum; (2) emission of irradiance of at least 30 µW/cm2/nm (in term infants); and (3) illumination of the exposed maximal body surface area of an infant (35% to 80%). Furthermore, accurate irradiance measurements should be performed using the appropriate irradiance meter calibrated for the wavelength range delivered by the phototherapy device.<h4>Conclusions</h4>With proper administration of effective phototherapy to an infant without concurrent hemolysis, total serum or plasma bilirubin concentrations will decrease within the first 4 to 6 hours of initiation safely and effectively.

ABSTRACT. Ebbesen, F. (Department of Neonatology, Rigshospitalet, Copenhagen, Denmark). Bilirubin, reserve albumin for binding of bilirubin and pH in plasma during phototherapy (ordinary and double light) of term newborn infants. Acta Paediatr Scand, 70:223, 1981. –Forty‐five term newborn infants with uncomplicated hyperbilirubinaemia were treated continuously with phototherapy for 24 hours. Twenty‐eight infants received double light treatment and 17 infants ordinary phototherapy. During both treatments a significant decrease in the serum unconjugated bilirubin concentration, a significant increase in the serum reserve albumin concentration for binding of bilirubin determined by the [14C] MADDS method, and a significant decrease in the index of serum bilirubin toxicity occurred. The changes in these parameters were significantly greater during the double light treatment than during the ordinary phototherapy. During the treatment the fall in index was constant. No significant change in plasma pH was seen. Thus, the study gives further evidence that the risk of bilirubin encephalopathy is reduced by phototherapy and that double light treatment is in the respect superior to ordinary phototherapy. Prior to phototherapy the molar ratio in serum of unconjugated bilirubin plus reserved albumin for binding of bilirubin to albumin was only 0.60, on average, and during the treatment the increase in the serum reserve albumin concentration was less than the decrease in the serum bilirubin concentration. This can be explained either by the presence in infant serum of an unknown ligand interfering competitively or allosterically in the binding of MADDS and bilirubin to albumin, or by the existence of a foetal albumin with a lower affinity for MADDS than adult albumin.

Neonatal hyperbilirubinemia is an extremely common metabolic complication of the neonatal period which may be associated with bilirubin encephalopathy and even death. Adverse neurological consequences are preventable if a timely diagnosis and treatment are provided. Phototherapy is usually the preferred option to decrease hyperbilirubinemia. Although considered to be safe, evidence in recent years has shown that this treatment may not be free of side effects and short- and long-term unfavorable outcomes. These are usually mild or rare, but should be decreased or avoided if possible. Many useful complementary measures and treatments have been described that could shorten the duration of exposure to phototherapy. However, there is no current unequivocal recommendation to use any of the methods presented in this review. Our review aims to depict the wide range of possible complementary treatments to phototherapy, and to provide the scientific and clinical evidence available regarding their usefulness. It is essential that, while utilizing the full potential of phototherapy to treat hyperbilirubinemia, caregivers are aware of its side effects and possible inherent dangers, and seek ways to minimize the exposure to phototherapy to what is really needed for the newborn. Further studies are needed to clarify the preferred complementary treatments that could reduce the duration of exposure to phototherapy without impairing its effectiveness.

Neonatal jaundice is a common condition observed in newborns shortly after birth, making it one of the most frequent health concerns during the first two weeks of life. This study, conducted between May 2019 and July 2023, enrolled 300 full-term infants with bilirubin levels exceeding 15 mg/dL on the fourth day after birth. The infants were recruited and randomly assigned in equal numbers to one of three groups for further investigation. In addition to the control group, the other two groups of infants received probiotic supplementation administered twice daily, with each capsule delivering 5 × 10⁹ CFU of either Lactobacillus salivarius AP-32 or Bifidobacterium animalis subsp. lactis CP-9. Both probiotic groups significantly reduced the overall duration of phototherapy and accelerated the rate of bilirubin reduction compared to the control group. The AP-32 group experienced a significant reduction in hospitalization duration, staying seven hours less than the placebo group (P = 0.024). Analysis of gut microbiota revealed that the probiotic groups significantly enhanced microbial diversity in the intestines of neonates. The AP-32 group showed a significant increase in the abundance of L. salivarius, while the CP-9 group demonstrated a notable enhancement in the abundance of B. animalis. These findings suggest that integrating phototherapy with probiotic supplementation may enhance jaundice clearance increasing the abundance of beneficial gut bacteria, thereby facilitating the recovery of neonates.

Phototherapy for ABO haemolytic hyperbilirubinaemia. The efficacy of 'standard' daylight phototherapy and 'high intensity' blue light phototherapy for neonatal jaundice from ABO-HD, or of a non-haemolytic nature was evaluated. Altogether 77 full-term infants with ABO-HD and 3,020 with non-haemolytic jaundice were studied. Both groups of infants responded well to standard daylight phototherapy; the response in non-haemolytic hyperbilirubinaemia was significantly greater. High intensity blue light phototherapy was significantly more effective in reducing bilirubin levels than standard daylight phototherapy in both group of infants with no failure being encountered. Four infants with non-haemolytic jaundice did not respond adequately to white light (1.4/1,000); they needed high intensity blue light for adequate response. Bilirubin rebound was mild. Four infants in the blue light group needed a second exposure (28.3/1,000) compared with 20 in the white light group (6.9/1,000), a difference that was significant. Standard white light phototherapy is usually adequate for ABO-HD as well as non-haemolytic hyperbilirubinaemia.

<h4>Background</h4>The clinical efficacy of intensive phototherapy for neonatal hyperbilirubinemia remains inconsistently reported across studies.<h4>Method</h4>The meta-analysis was conducted in accordance with PRISMA 2020 and MOOSE guidelines. We searched Web of Science, PubMed, Embase, and ScienceDirect for eligible comparative studies from the inception of the databases up to March, 2026. The primary outcome was the reduction in total serum bilirubin (TSB) levels from baseline to the completion of phototherapy, and the duration of phototherapy was defined as the secondary outcome. The pooled results were synthesized via random-effect model. Influential publication was determined by performing sensitivity analysis. In addition, the potential sources of heterogeneity were examined by using subgroup analyses. Publication bias was assessed using the funnel plot, Begg's and Egger's tests.<h4>Result</h4>The 12 included studies (8 RCTs and 4 cohort studies) published between 1995 and 2026, enrolling 1,144 neonates with mean gestational age ranging from 30 to 39 weeks and baseline TSB levels from 172 to 390 μmol/L. Intensive phototherapy achieved significantly greater TSB reductions compared to conventional phototherapy within the same timeframe (MD = -21.87, 95% CI = -29.69 to -14.05, <i>p</i> < 0.001, I² = 83.9%). Subgroup analysis showed that the gestational age (<i>p</i> = 0.003) and baseline TSB level (<i>p</i> = 0.005) were potential source of heterogeneity, but study design was not (<i>p</i> = 0.106). In addition, the treatment duration from the intensive phototherapy group were shorter than the conventional group (MD = -20.23 h, 95% CI = -38.91 to -1.54, <i>p</i> = 0.034, I² = 94.7%). No influential publications and significant publication bias were detected across the 12 studies.<h4>Conclusion</h4>Phototherapy has been established as the cornerstone of clinical management for neonatal hyperbilirubinemia. Intensive phototherapy demonstrates superior clinical efficacy in reducing TSB levels and treatment duration than conventional phototherapy, especially in preterm neonates with severe hyperbilirubinemia.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/PROSPERO/view/CRD420261324708, Identifier CRD420261324708.

in bilirubin isomerize when exposed to light. This isomerization is relevant to the phototherapy of jaundiced newborns: the E,Z-isomers of bilirubin formed Bilirubin (BR) (adopted from German, originally bili, for bile, plus ruber, Latin for red) is a red-orange compound that occurs as the reduction product of biliverdin, a breakdown product of heme. It is further broken down in the colon to urobilinogen, most of which becomes stercobilin, causing the brown color of feces. Some unconverted urobilinogen, metabolised to urobilin, provides the straw-ye Bili… Hemoglobin acts to transport oxygen which the body receives to all body tissue via blood vessels. Over time, when red blood cells need to be replenished, the hemoglobin is broken down in the spleen; it breaks down into two parts: heme group consisting of iron and bile, and protein fraction.…

hypoplasia. The therapy uses a blue light (420–470 nm) that converts bilirubin into an (E,Z)-isomer that can be excreted in the urine and feces. Soft goggles A bili light is a light therapy tool to treat newborn jaundice (hyperbilirubinemia). High levels of bilirubin can cause brain damage (kernicterus), leading to cerebral palsy, auditory neuropathy, gaze abnormalities and dental enamel hypoplasia. The therapy uses a blue light (420–470 nm) that converts bilirubin into an (E,Z)-isomer that can be excreted in the urine and feces. Soft goggles are put A bili light is a light therapy tool to treat newborn jaundice (hyperbilirubinemia). High levels of bilirubin can cause brain damage (kernicterus), leading to cerebral palsy, auditory neuropathy, gaze abnormalities and dental enamel hypoplasia. The therapy uses a blue light (420–470 nm) that converts bilirubin into an (E,Z)-isomer that can be excreted in the urine and feces. Soft goggles are put on the child to reduce eye damage from the high intensity light. The baby is kept naked or only wearing a diaper, and is turned over frequently to expose more of the skin. Conventional bili lights shine from above the baby. A biliblanket consists of a fiber-optic blanket designed to transfer the light from a lamp unit all around the baby's body, and is more commonly used at home. A biliblanket is a portable phototherapy device used to treat neonatal jaundice (hyperbilirubinemia). BiliBlanket is a trademark of General Electric's Datex-Ohmeda subsidiary, but its name has become the generic, colloquial term for a range of similar products and the term used in the medical professions. The name "biliblanket" combines the words bilirubin and blanket. The baby is placed in direct contact with the pad. This device is also known as home phototherapy system, bilirubin blanket, or bidirectional fiber-optic phototherapy blanket. Different types of phototherapy for jaundice involve a blue light of varying types of light, wavelengths, and degrees of irradiance. The light waves promote breakdown of bilirubin and allow it to be eliminated. Compared to standard forms of phototherapy, a biliblanket utilizes a fiberoptic system, allowing them to be used at home. The biliblanket system consists of three components: an illuminator, fiberoptic pad, and disposable pad cover. The fiberoptic pad is used to transport blue or white light from the light source, the illuminator, directly onto the baby's skin.